Skip to main content
NCBI home page
The Journal of Clinical Investigation logoLink to The Journal of Clinical Investigation
. 1997 Apr 15;99(8):1873–1879. doi: 10.1172/JCI119354

Impaired microvascular dilatation and capillary rarefaction in young adults with a predisposition to high blood pressure.

J P Noon 1, B R Walker 1, D J Webb 1, A C Shore 1, D W Holton 1, H V Edwards 1, G C Watt 1
PMCID: PMC508011  PMID: 9109431

Abstract

Increased vascular resistance in essential hypertension occurs mainly in microvessels with luminal diameters < 100 microm. It is not known whether abnormalities in these vessels are a cause or consequence of high blood pressure (BP). We studied 105 men (aged 23-33 yr) in whom predisposition to high blood pressure has been characterized by both their own BP and those of their parents. Factors that are secondary to high BP correlate with offspring BP irrespective of parental BP, but factors that are components of the familial predisposition to high BP are more closely associated with higher BP in offspring whose parents also have high BP. Offspring with high BP whose parents also have high BP had impaired dermal vasodilatation in the forearm following ischemia and heating (289+/-27 [n = 25] versus 529+/-40 [n = 26], 476+/-38 [n = 30], and 539+/-41 flux units [n = 24] in other groups; P < 0.0001) and fewer capillaries on the dorsum of the finger (23+/-0.8 capillaries/0.25 mm2 versus 26+/-0.8 in all other groups; P < 0.003). Except for BP, other hemodynamic indices (including cardiac output and forearm vascular resistance) were not different. The dermal vessels of men who express a familial predisposition to high BP exhibit increased minimum resistance and capillary rarefaction. Defective angiogenesis may be an etiological component in the inheritance of high BP.

Full Text

The Full Text of this article is available as a PDF (178.0 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barker D. J., Bull A. R., Osmond C., Simmonds S. J. Fetal and placental size and risk of hypertension in adult life. BMJ. 1990 Aug 4;301(6746):259–262. doi: 10.1136/bmj.301.6746.259. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Conroy R. M., O'Brien E., O'Malley K., Atkins N. Measurement error in the Hawksley random zero sphygmomanometer: what damage has been done and what can we learn? BMJ. 1993 May 15;306(6888):1319–1322. doi: 10.1136/bmj.306.6888.1319. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Duprez D., De Buyzere M., De Backer T., Vercammen J., Brusselmans F., Clement D. L. Impaired microcirculation in mild-to-moderate essential arterial hypertension. J Hypertens. 1992 Mar;10(3):251–254. doi: 10.1097/00004872-199203000-00008. [DOI] [PubMed] [Google Scholar]
  4. FOLKOW B., GRIMBY G., THULESIUS O. Adaptive structural changes of the vascular walls in hypertension and their relation to the control of the peripheral resistance. Acta Physiol Scand. 1958 Dec 15;44(3-4):255–272. doi: 10.1111/j.1748-1716.1958.tb01626.x. [DOI] [PubMed] [Google Scholar]
  5. Fagrell B., Rosén L., Eriksson S. E. Comparison between a new computerized and an analogue videophotometric, cross-correlation technique for measuring skin capillary blood cell velocity in humans. Int J Microcirc Clin Exp. 1994 May-Jun;14(3):133–138. doi: 10.1159/000105065. [DOI] [PubMed] [Google Scholar]
  6. Flynn M. D., Williams S. A., Tooke J. E. Clinical television microscopy. J Med Eng Technol. 1989 Nov-Dec;13(6):278–284. doi: 10.3109/03091908909016202. [DOI] [PubMed] [Google Scholar]
  7. Folkow B. "Structural factor" in primary and secondary hypertension. Hypertension. 1990 Jul;16(1):89–101. doi: 10.1161/01.hyp.16.1.89. [DOI] [PubMed] [Google Scholar]
  8. Gasser P., Bühler F. R. Nailfold microcirculation in normotensive and essential hypertensive subjects, as assessed by video-microscopy. J Hypertens. 1992 Jan;10(1):83–86. doi: 10.1097/00004872-199201000-00013. [DOI] [PubMed] [Google Scholar]
  9. Harper R. N., Moore M. A., Marr M. C., Watts L. E., Hutchins P. M. Arteriolar rarefaction in the conjunctiva of human essential hypertensives. Microvasc Res. 1978 Nov;16(3):369–372. doi: 10.1016/0026-2862(78)90070-5. [DOI] [PubMed] [Google Scholar]
  10. Harrap S. B., Davidson H. R., Connor J. M., Soubrier F., Corvol P., Fraser R., Foy C. J., Watt G. C. The angiotensin I converting enzyme gene and predisposition to high blood pressure. Hypertension. 1993 Apr;21(4):455–460. doi: 10.1161/01.hyp.21.4.455. [DOI] [PubMed] [Google Scholar]
  11. Harrap S. B., Dominiczak A. F., Fraser R., Lever A. F., Morton J. J., Foy C. J., Watt G. C. Plasma angiotensin II, predisposition to hypertension, and left ventricular size in healthy young adults. Circulation. 1996 Mar 15;93(6):1148–1154. doi: 10.1161/01.cir.93.6.1148. [DOI] [PubMed] [Google Scholar]
  12. Harrap S. B., Samani N. J., Lodwick D., Connor J. M., Fraser R., Davies D. L., Lever A. F., Foy C. J., Watt G. C. The SA gene: predisposition to hypertension and renal function in man. Clin Sci (Lond) 1995 Jun;88(6):665–670. doi: 10.1042/cs0880665. [DOI] [PubMed] [Google Scholar]
  13. Heagerty A. M., Aalkjaer C., Bund S. J., Korsgaard N., Mulvany M. J. Small artery structure in hypertension. Dual processes of remodeling and growth. Hypertension. 1993 Apr;21(4):391–397. doi: 10.1161/01.hyp.21.4.391. [DOI] [PubMed] [Google Scholar]
  14. Henrich H. A., Romen W., Heimgärtner W., Hartung E., Bäumer F. Capillary rarefaction characteristic of the skeletal muscle of hypertensive patients. Klin Wochenschr. 1988 Jan 15;66(2):54–60. doi: 10.1007/BF01713011. [DOI] [PubMed] [Google Scholar]
  15. Hudetz A. G. Percolation phenomenon: the effect of capillary network rarefaction. Microvasc Res. 1993 Jan;45(1):1–10. doi: 10.1006/mvre.1993.1001. [DOI] [PubMed] [Google Scholar]
  16. LANDAU J., DAVIS E. Capillary thinning and high capillary blood-pressure in hypertension. Lancet. 1957 Jun 29;272(6983):1327–1330. doi: 10.1016/s0140-6736(57)91847-0. [DOI] [PubMed] [Google Scholar]
  17. Lever A. F., Harrap S. B. Essential hypertension: a disorder of growth with origins in childhood? J Hypertens. 1992 Feb;10(2):101–120. doi: 10.1097/00004872-199202000-00001. [DOI] [PubMed] [Google Scholar]
  18. Lucarini A. R., Spessot M., Picano E., Marini C., Lattanzi F., Pedrinelli R., Salvetti A. Lack of correlation between cardiac mass and arteriolar structural changes in mild-to-moderate hypertension. J Hypertens. 1991 Dec;9(12):1187–1191. [PubMed] [Google Scholar]
  19. MRC trial of treatment of mild hypertension: principal results. Medical Research Council Working Party. Br Med J (Clin Res Ed) 1985 Jul 13;291(6488):97–104. doi: 10.1136/bmj.291.6488.97. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Northridge D. B., Findlay I. N., Wilson J., Henderson E., Dargie H. J. Non-invasive determination of cardiac output by Doppler echocardiography and electrical bioimpedance. Br Heart J. 1990 Feb;63(2):93–97. doi: 10.1136/hrt.63.2.93. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. PATTERSON G. C., WHELAN R. F. Reactive hyperaemia in the human forearm. Clin Sci. 1955 May;14(2):197–211. [PubMed] [Google Scholar]
  22. Pedrinelli R., Spessot M., Salvetti A. Reactive hyperemia during short-term blood flow and pressure changes in the hypertensive forearm. J Hypertens. 1990 May;8(5):467–471. doi: 10.1097/00004872-199005000-00012. [DOI] [PubMed] [Google Scholar]
  23. Prasad A., Dunnill G. S., Mortimer P. S., MacGregor G. A. Capillary rarefaction in the forearm skin in essential hypertension. J Hypertens. 1995 Feb;13(2):265–268. [PubMed] [Google Scholar]
  24. Rayman G., Williams S. A., Spencer P. D., Smaje L. H., Wise P. H., Tooke J. E. Impaired microvascular hyperaemic response to minor skin trauma in type I diabetes. Br Med J (Clin Res Ed) 1986 May 17;292(6531):1295–1298. doi: 10.1136/bmj.292.6531.1295. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Shore A. C., Tooke J. E. Microvascular function in human essential hypertension. J Hypertens. 1994 Jul;12(7):717–728. [PubMed] [Google Scholar]
  26. Sullivan J. M., Prewitt R. L., Josephs J. A. Attenuation of the microcirculation in young patients with high-output borderline hypertension. Hypertension. 1983 Nov-Dec;5(6):844–851. doi: 10.1161/01.hyp.5.6.844. [DOI] [PubMed] [Google Scholar]
  27. Takeshita A., Imaizumi T., Ashihara T., Yamamoto K., Hoka S., Nakamura M. Limited maximal vasodilator capacity of forearm resistance vessels in normotensive young men with a familial predisposition to hypertension. Circ Res. 1982 May;50(5):671–677. doi: 10.1161/01.res.50.5.671. [DOI] [PubMed] [Google Scholar]
  28. WHITNEY R. J. The measurement of volume changes in human limbs. J Physiol. 1953 Jul;121(1):1–27. doi: 10.1113/jphysiol.1953.sp004926. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Watt G. C., Foy C. J., Holton D. W., Edwards H. E. Prediction of high blood pressure in young people: the limited usefulness of parental blood pressure data. J Hypertens. 1991 Jan;9(1):55–58. [PubMed] [Google Scholar]
  30. Watt G. C., Harrap S. B., Foy C. J., Holton D. W., Edwards H. V., Davidson H. R., Connor J. M., Lever A. F., Fraser R. Abnormalities of glucocorticoid metabolism and the renin-angiotensin system: a four-corners approach to the identification of genetic determinants of blood pressure. J Hypertens. 1992 May;10(5):473–482. doi: 10.1097/00004872-199205000-00011. [DOI] [PubMed] [Google Scholar]
  31. Webb D. J. The pharmacology of human blood vessels in vivo. J Vasc Res. 1995 Jan-Feb;32(1):2–15. doi: 10.1159/000159072. [DOI] [PubMed] [Google Scholar]
  32. Widgren B. R., Berglund G., Wikstrand J., Andersson O. K. Reduced venous compliance in normotensive men with positive family histories of hypertension. J Hypertens. 1992 May;10(5):459–465. doi: 10.1097/00004872-199205000-00009. [DOI] [PubMed] [Google Scholar]
  33. Williams S. A., Tooke J. E. Noninvasive estimation of increased structurally-based resistance to blood flow in the skin of subjects with essential hypertension. Int J Microcirc Clin Exp. 1992 Feb;11(1):109–116. [PubMed] [Google Scholar]
  34. Wright B. M., Dore C. F. A random-zero sphygmomanometer. Lancet. 1970 Feb 14;1(7642):337–338. doi: 10.1016/s0140-6736(70)90709-9. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Investigation are provided here courtesy of American Society for Clinical Investigation

RESOURCES